Which of the following diagnostic tests should be performed annually over age 50 to screen for colon cancer?
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Solution
Fecal occult blood test
Surface blood vessels of polyps and cancers are fragile and often bleed with the passage of stools. Abdominal x-ray and CT scan can help establish tumor size and metastasis. A colonoscopy can help locate a tumor as well as polyps, which can be removed before they become malignant.
Which of the following diets is most commonly associated with colon cancer?
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Solution
Low-fiber, high fat
A low-fiber, high-fat diet reduced motility and increases the chance of constipation. The metabolic end products of this type of diet are carcinogenic. A low-fat, high-fiber diet is recommended to prevent colon cancer.
Colon cancer is most closely associated with which of the following conditions?
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Solution
Ulcerative colitis
Chronic ulcerative colitis, granulomas, and familial polyposis seem to increase a person’s chance of developing colon cancer. The other conditions listed have no known effect on colon cancer risk.
During the first few days of recovery from ostomy surgery for ulcerative colitis, which of the following aspects should be the first priority of client care?
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Solution
Ostomy care
Although all of these are concerns the nurse should address, being able to safely manage the ostomy is crucial for the client before discharge.
Which of the following medications is most effective for treating the pain associated with irritable bowel disease?
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Solution
Steroids
The pain with irritable bowel disease is caused by inflammation, which steroids can reduce. Stool softeners aren’t necessary. Acetaminophen has little effect on the pain, and opiate narcotics won’t treat its underlying cause.
Surgical management of ulcerative colitis may be performed to treat which of the following complications?
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Solution
Bowel perforation
Perforation, obstruction, hemorrhage, and toxic megacolon are common complications of ulcerative colitis that may require surgery. Herniation and gastritis aren’t associated with irritable bowel diseases, and outpouching of the bowel is diverticulosis.
In a client with Crohn’s disease, which of the following symptoms should not be a direct result of antibiotic therapy?
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Solution
Decrease in body weight
A decrease in body weight may occur during therapy due to inadequate dietary intake, but isn’t related to antibiotic therapy. Effective antibiotic therapy will be noted by a decrease in temperature, number of stools, and bleeding.
Which of the following interventions should be included in the medical management of Crohn’s disease?
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Solution
Using long-term steroid therapy
Management of Crohn’s disease may include long-term steroid therapy to reduce the inflammation associated with the deeper layers of the bowel wall. Other management focuses on bowel rest (not increasing oral intake) and reducing diarrhea with medications (not giving laxatives). The pain associated with Crohn’s disease may require bed rest, not an increase in physical activity.
If a client had irritable bowel syndrome, which of the following diagnostic tests would determine if the diagnosis is Crohn’s disease or ulcerative colitis?
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Solution
Colonoscopy with biopsy
A colonoscopy with biopsy can be performed to determine the state of the colon’s mucosal layers, presence of ulcerations, and level of cytologic development. An abdominal x-ray or CT scan wouldn’t provide the cytologic information necessary to diagnose which disease it is. A barium swallow doesn’t involve the intestine.
Which of the following symptoms is associated with ulcerative colitis?
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Solution
Rectal bleeding
In ulcerative colitis, rectal bleeding is the predominant symptom. Soft stools are more commonly associated with Crohn’s disease, in which malabsorption is more of a problem. Dumping syndrome occurs after gastric surgeries. Fistulas are associated with Crohn’s disease.